With the advances in technology, most patients desire to maintain their natural dentition, when earlier they would have chosen extraction. Endo-perio lesions can be successfully managed with multidisciplinary approach and choice of treatment. Hemisection is one such procedure, where a multi-rooted tooth is sectioned with its crown portion and removed for cases with a loss of periodontal attachment and the original tooth structure is retained and restored with a fixed prosthesis. But for long term success, careful case selection is of prime importance. This case report aims at reviewing the management of endo-perio lesions and presents a case report of hemisection.